Medical eligibility,contraceptive choice,and intrauterine device acceptance among HIV-infected women receiving antiretroviral therapy in Lilongwe,Malawi |
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Authors: | Lisa B Haddad Caryl Feldacker Denise J Jamieson Hannock Tweya Carrie Cwiak Amy G Bryant Mina C Hosseinipour Thomas Chaweza Linly Mlundira Fanny Kachale Gretchen S Stuart Irving Hoffman Sam Phiri |
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Institution: | 1. Emory University, Department of Gynecology and Obstetrics, Atlanta, USA;2. The Lighthouse Trust, Lilongwe, Malawi;3. International Training and Education Center for Health (I-TECH), University of Washington, Seattle, USA;4. University of North Carolina-Chapel Hill, Chapel Hill, USA;5. University of North Carolina Project-Malawi, Lilongwe, Malawi;6. Reproductive Health Services, Ministry of Health, Lilongwe, Malawi |
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Abstract: | ObjectiveTo determine medical eligibility for contraceptive use, contraceptive preference, and acceptance of a copper intrauterine device (IUD) among a cohort of HIV-infected women receiving antiretroviral therapy (ART).MethodsAll HIV-infected women who received ART and sought contraceptive services at the Lighthouse clinic, an integrated HIV/ART clinic in Lilongwe, Malawi, between August and December 2010 were invited to participate in a structured interview. Eligibility and preference for the following contraceptive methods were assessed: combined hormonal contraceptives, progestogen-only pills, copper IUD, injectable depot medroxyprogesterone acetate (DMPA), and contraceptive implants.ResultsThe final sample included 281 women; five were pregnant. The remaining 276 women were eligible for at least three contraceptive methods, with 242 (87.7%) eligible for all five methods evaluated. After counseling, 163 (58.0%) selected DMPA and 98 (34.9%) selected an IUD as their preferred contraceptive method. Regardless of their method of choice, 222 (79.0%) women agreed to have an IUD placed on the same day.ConclusionMost methods of contraception are safe for use by HIV-infected women. Approximately 80% of the women were willing to receive an IUD. Efforts must be made to increase education about, and access to, long-acting reversible methods that may be acceptable and appropriate contraceptive options for HIV-infected women. |
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Keywords: | Antiretroviral therapy Contraception HIV Intrauterine contraception Intrauterine device Malawi Medical eligibility |
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